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Maryland Insurance Administration Accident-and-Health-or-Sickness-Producer Exam Syllabus Topics:

SectionWeightObjectives
Topic 1: Maryland State-Specific Regulations20%- Statutory Requirements
  • 1. Claims handling and settlement rules
    • 2. Disclosure and marketing requirements
      • 3. Mandatory benefits and coverage mandates
        - Compliance and Enforcement
        • 1. Reporting and recordkeeping
          • 2. Penalties and violations
            Topic 2: General Insurance Concepts15%- Fundamental Principles
            • 1. Risk and risk management
              • 2. Insurable interest and indemnity
                • 3. Contract law and policy structure
                  - Policy Provisions
                  • 1. Mandatory and optional clauses
                    • 2. Exclusions and limitations
                      Topic 3: Insurance Regulation30%- Regulation of Producers
                      • 1. Unfair trade practices
                        • 2. Compensation and commissions
                          • 3. Privacy and confidentiality rules
                            - Licensing
                            • 1. Initial qualifications and examination
                              • 2. License issuance, renewal, and termination
                                • 3. General provisions and definitions
                                  - Providers and Markets
                                  • 1. HMOs and managed care arrangements
                                    • 2. Insurers and health service organizations
                                      Topic 4: Accident and Health Insurance Policies35%- Types of Coverage
                                      • 1. Medical expense insurance
                                        • 2. Long-term care insurance
                                          • 3. Accident-only coverage
                                            • 4. Disability income insurance
                                              - Policy Features
                                              • 1. Benefit structures and limits
                                                • 2. Waiting periods and elimination periods
                                                  • 3. Pre-existing conditions and exclusions

                                                    Maryland Insurance Administration MarylandAccident and Health or Sickness Producer Series 20-24 Sample Questions:

                                                    Question 1

                                                    Which one of the following causes of loss typically is EXCLUDED under a disability income insurance policy?

                                                    A. Tropical disease
                                                    B. Intentionally self-inflicted injuries
                                                    C. Cancer
                                                    D. Auto accidents


                                                    Question 2

                                                    Misrepresenting pertinent policy provisions relating to coverages after a loss is:

                                                    A. An unfair discrimination between individuals
                                                    B. A concealment in insurance applications
                                                    C. An unfair claim settlement practice
                                                    D. A violation of the principle of adhesion


                                                    Question 3

                                                    A policy of life insurance may NOT be delivered unless the policy has a:

                                                    A. Premium coupon book
                                                    B. Legible and brief description of the policy on the first page
                                                    C. Financial statement of the life insurance company
                                                    D. Notary seal


                                                    Question 4

                                                    A producer may be guilty of misrepresentation if the producer:

                                                    A. Required timely written notice of loss for all claims
                                                    B. Issued a full settlement check expressly releasing the insurer
                                                    C. Denied a claim for failure of the policyholder to prove damages
                                                    D. Failed to disclose exclusions of the policy


                                                    Question 5

                                                    An insurance adviser's written contract with the client must include all of the following EXCEPT:

                                                    A. Amount of the fee
                                                    B. Expiration date of the consultant's license
                                                    C. Duration of the contract
                                                    D. Disclosure as to whether commissions may be received


                                                    Solutions:

                                                    Question 1
                                                    Answer: B
                                                    Question 2
                                                    Answer: C
                                                    Question 3
                                                    Answer: B
                                                    Question 4
                                                    Answer: D
                                                    Question 5
                                                    Answer: B

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